Depression: The Parasitic Load

In 2016, depression was still ranked as the world’s number 2 disabling disorder but it has now outranked heart disease to become the world’s most disabling disorder. According to the World Health Organisation, around 264 million people world-wide are suffering from depression and the numbers are still on the rise. Nonetheless, a lot of depression cases are still unreported and untreated due to the stigma against depression that are held by the general public. For example, depression is frequently regarded as a sign of weakness and individuals with depression are often blamed for being not appreciative of their life or do not hold strong beliefs. This has instilled a strong sense of shame and guilt in individuals who are suffering from depression which make them hesitant to reach out for help. Therefore, increased awareness about depression is the key that enables us to gain victory in the human’s long history of battle against this debilitating mental health disorder. 

What depression is and what depression is not?

To clear up misconceptions about depression, it is essential to first understand what depression is and what depression is not. 

Symptoms of depression:

• Persistent sadness
• Loss of interest or pleasure in activities that one used to enjoy
• Significant weight gain or weight loss that is unrelated to diet
• Insomnia (not getting enough sleep) or hypersomnia (sleep too much)
• Feelings of inappropriate guilt and worthlessness
• Fatigue or loss of energy
• Impaired cognitive abilities such as difficulties in concentrating and making decisions
• Recurrent thoughts of death and suicidal attempts

Depression is not the same as sadness or grief:

Although unpleasurable experiences such as failing an exam, losing a job, ending a relationship or the death of a loved one might induce feelings of sadness or grief, experiencing these emotions does not necessarily mean that a person is suffering from depression.

How is depression distinct from sadness or grief?

1. Sadness usually arises in response to a particular life situation. On the other hand, the onset of depression does not require any specific trigger because an individual might still develop depression even though he or she never experienced any distressing or unpleasant life events. 
2. Sadness can be relieved by activities that someone finds interesting such as watching television, listening to music or playing games. However, the low mood in depression is unlikely to be reversed by pleasurable activities because most individuals with depression have lost their ability to experience joy in most of their life events. 
3. Barbara Kingslover once provided an analogy in her novel The Bean Trees to portray the difference between sadness and depression: “Sadness is more or less like a head cold—with patience, it passes. Depression is like a cancer”. Sadness normally fades off over time but depression involves a persistent experience of sadness which lasts for a very long period of time. 
4. Individuals who are experiencing grief of bereavement are preoccupied by memories of the deceased but those with depression are pre-occupied by self-critical thoughts.
5. Self-esteem is normally preserved in grief but not in depression. Self-loathing and feelings of worthlessness are common in depression.
6. When a person experiences grief for bereavement, thoughts of death are associated with reunion with the deceased. When thinking about death, individuals with depression on the other hand intend to end their life because they want to escape from the agonizing feeling which arises from their strong sense of self-worthlessness.

Types of depression

Despite featuring similar characteristics, there are different classifications of depressive disorder based on DSM-V. Two common types of depression are highlighted as below:

Major Depressive Disorder (MDD)

MDD is the most common type of depression which is marked by depressive episodes (either depressed mood or loss of pleasure/interest in activities) that last for at least 2 weeks. 

Persistent Depressive Disorder (PDD)/ Dysthymia

Unlike individuals with MDD that have a normal mood in non-depressive episodes, PDD is a chronic form of depression. It is diagnosed when the depressive symptoms have persisted for at least 2 years but the intensity of the symptoms are not as high as MDD.

Causes of depression

Depression is not simply a ‘product’ of a single cause. Instead, there has been a growing consensus that there are multiple ways to depression:

Genetics

The genetic makeup of a person might predispose him or her to depression. Research shows that depression is more likely in individuals who have a first-degree relative suffering from depression. 

Biochemical

Several biochemical hypotheses have been proposed as viable explanations for the onset of depression. The most well-known theory of depression is the monoamine theory, which suggests that depression is caused by insufficient levels of monoamines (e.g., serotonin, dopamine and norepinephrine).

Environmental stressors

Stress is a precursor of the development of depression because prolonged exposure to stressful environments could stimulate changes in the brain and increase the secretion of stress hormone in the body that might induce depression. 

Cognitive thought patterns

Although stressful life events might trigger the onset of depression, interpretation of personal experiences is also an important element that leads to the onset of depression. Individuals with depression usually adopt a pessimistic attributional style and view the self, world as well as their future in a negative light.

What do I do if I have depression?

Although depression is a debilitating mental health disorder, recovery from depression is possible with proper treatment. If you are suffering from depression, it is important to bear in mind that depression is not a sign of weakness and it is not something that you need to be ashamed of. It is advisable to get proper treatments from the mental health practitioners because they are experienced and could provide professional support that you need.“Depending on the severity, treatment of depression may often involve a combination of antidepressant drugs and psychotherapy (e.g., cognitive behavioural therapy) to restore the biochemical level of the brain as well as restructuring the maladaptive cognitive styles. Other than seeking for treatments and consuming the medications that are prescribed, here are some self-coping strategies that you could apply in your daily life:

Get enough rest

Depression is often related to not being able to get enough sleep. A good quality of sleep is essential to maintain a positive mood. Try having an eight hours sleep daily to keep you energised for the next day.

Perform regular exercise

Mood elevation is observed after exercising because exercise promotes the generation of new neurons that were suggested to have antidepressant effects.

Practice a depression-fighting diet

Since omega-3 fatty acid was suggested to have mood-stabilising effect, consumption of food that is rich in omega-3 fatty acids such as salmon, tuna, and sardine can support the recovery. Besides that, avoid taking substances that might adversely affect the brain chemical such as alcohol and caffeine.

Build a support group

Surround yourself with people who are able to provide emotional support to you. Try to open your heart to share your thoughts and emotions to the people that you feel comfortable with because this could make you more relieved from depression.

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